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Intrapulmonary Lymph Nodes: Thin-Section CT Features of 19 Nodules

Oshiro, Yasuji; Kusumoto, Masahiko; Moriyama, Noriyuki; Kaneko, Masahiro; Suzuki, Kenji; Asamura, Hisao; Kondo, Haruhiko; Tsuchiya, Ryousuke; Murayama, Sadayuki

Journal of Computer Assisted Tomography: July/August 2002 - Volume 26 - Issue 4 - pp 553-557
Thoracic Imaging

Purpose: The purpose of this study was to describe the thin-section CT features of intrapulmonary lymph nodes that accompanied primary or metastatic lung tumors.

Method: A retrospective analysis of thin-section CT features was performed on 19 nodules in 16 patients with pathologically confirmed intrapulmonary lymph nodes that accompanied primary or metastatic lung tumors.

Results: Of the 16 patients, 13 had a solitary nodule and 3 had two nodules. All nodules were distributed in the middle lobe, lingula, or lower lobe. On thin-section CT images, the nodule was located abutting the visceral pleura (n = 10) or within 8 mm of the visceral pleura (n = 9). The thin-section CT findings showed that most of the nodules were well circumscribed (n = 18), homogeneous (n = 19), ovoid (n = 10), or round (n = 9) and smaller than 12 mm in maximal diameter. The surrounding lung field was normal (n = 16).

Conclusion: Intrapulmonary lymph nodes are subpleural in the lower lung field. On thin-section CT, they are well circumscribed, homogeneous, round or ovoid, and smaller than 12 mm in maximal diameter. In the differential diagnosis of subpleural nodules located in the lower lung field, it should be kept in mind that they may be intrapulmonary lymph nodes even though the patient has malignancy.

From the Department of Radiology, University of Ryukyu School of Medicine, Okinawa Prefecture (Y. Oshiro), and Departments of Diagnostic Radiology (M. Kusumoto and N. Moriyama), Diagnostic Endoscopy (M. Kaneko), and Surgery (K. Suzuki, H. Asamura, H. Kondo, and R. Tsuchiya), National Cancer Center Hospital, Tokyo, Japan.

Address correspondence to Dr. Y. Oshiro at Department of Radiology, University of Ryukyu School of Medicine, 207 Uehara, Nishihara-cho, Okinawa Pref., Japan 903-0215. E-mail: Oshiro4211@aol.com

© 2002 Lippincott Williams & Wilkins, Inc.